Conceptual Framework: Community Monitoring for Accountability

What is Community Monitoring? 

Community Monitoring (also called citizen oversight or social accountability) is a set of activities, or a process, which is conducted by communities or a group of community representatives to understand the accessibility, quality and effectiveness of public services that the community is entitled to. Some of the key elements of a community monitoring process are as follows:
  1. It is a community owned, and directed process
  2. It is around a public programme or entitlement
  3. It includes processes which allow the community to collate and share its experiences of service delivery
  4. The collation and presentation of information is against the yardstick of the communities own entitlements; ; it may also include the comparison of communities own experiences against programme related data
  5. It allows for evidence based feedback and engagement with a public system to ensure improvement in programme design and delivery as well as recording and addressing of grievances
Community Monitoring is a form of citizen oversight, driven by local needs, expectations and experiences, drawing upon communitarian values, to increase the accountability and quality of social sector services, in this case health services. As a result of this process members of a community who are the intended recipients of the health services generate demands, suggestions, critiques and data that they then feeds back to the public organisation implementing the program or managing the services. Community Monitoring not only seeks to generate the appropriate information for high quality service delivery but also aims to strengthen local decision-making, public education, community capacity and effective public participation in local government. Ultimately, it is a tool to facilitate more inclusive decision-making on issues deemed important to members of a community that incorporate increasingly complex aspects of social, economic and environmental factors. 

Community Monitoring is predicated on some conditions/mechanisms and processes, and can lead to some outcomes/situations which are explored below.

Preconditions about State Mechanisms
The ‘state’ or country in which community monitoring exercises are being proposed/ explored 
  • has accepted some health related international human rights standards within its domestic constitutional and policy making framework
  • provides space to civil society to engage in citizenship promoting activities like community empowerment, studies to understand/critique state policy and programming.
  • has spaces within its programme implementation framework for review and planning
  • accepts the principle that public documents/records may be open to public view
 
Preconditions about Status of Civil Society
In order that community monitoring is successful it is necessary that civil society organisations in such countries/states
  • are interested in citizenship and governance issues and informed about human rights principles and rights based approaches
  • are linked with disadvantaged communities and their interests and informed about their experiences of service delivery.
  • have relationship with or are interested in developing relationships with state functionaries and institutions
  • have some capacity to or are open to building capacity in conduct research, mobilise communities and facilitate dialogue with state functionaries
 
Operational Mechanisms
The following steps may be considered integral to developing community monitoring mechanism with the active participation of marginalised communities around the domain of health
  • Mobilisation and Entitlement Awareness - marginalised communities will be mobilised around their health entitlements and lack of corresponding health services. They will take leadership in engaging with local government officials for negotiating improved health services. These will initially require the facilitation and support of a (local) NGO.
  • Capacity Building for enquiry - Leaders from within the mobilised communities with the support of a facilitating NGO will develop skills in assessing the health status and health services utilised by the community, and for negotiating with local government officials on the basis of the information that they have collected.
  • Negotiating with local government officials – The local government officials will provide space to members from the communities and their leadership to present their own experiences / and evidence about problems faced in accessing and utilising existing health services. The facilitating NGOs will support in creating such a space for dialogue.
  • Develop an ongoing process - It is not enough to collect information only once or occasionally. Instead, if the information seeking process is ongoing and regular, then it is also possible to make timely improvements in the services.
  • Combination of monitoring and planning — Representative committees should not limit itself to collecting information, but should also be involved in planning of health services at a local level.
  • Monitoring at multiple levels —While it may be possible to address or seek solutions to a large number of problems in accessing quality health services at the local level, not all problems are amenable to local solutions. It is thus necessary to link the process of community monitoring to a larger process of advocacy which allows more deeply embedded systemic issues to be address.
  • Collaborative Advocacy – Organisations working on health rights issues will work together for advocacy around health.  Community based organisations will develop relationships with other human rights/social justice organisations and this will lead to mutual support for each others issues.
  • Forums for Accountability will fulfill their stated functions – When approached by Communities/their Leadership/Facilitating NGOs on issues of health service delivery  established forums for accountability like Ombudsman’s office will entertain the reports. They will issue the necessary directions to practitioners and government bodies to follow the appropriate policy guidelines relating to fulfillment of health rights.

Anticipated Outcomes
The community monitoring mechanism is expected to lead to the following outcomes
  • Members of marginalised communities will be mobilised and discuss their health and other social development issues at traditional or newly developed community platforms
  • There will be increased communication between leaders of the community and local health providers and with leadership of the CSO - NGO coalition with district/provincial/national health managers and policy makers
  • Gaps in policy making and programme implementation will be identified and solutions developed
  • There will be improvements in the access and utilisation of essential services within the core package (as identified in the specific context)
  • There will be improvement in health outcomes ( in a slightly longer run).